Death on a Sunny Saturday

“I’m sure you’re all excited to come out on a Saturday morning on a beautiful day in New York City to talk about death,” Atul Gawande–a staff writer for the magazine, practicing surgeon at Brigham and Women’s Hospital, in Boston, and an associate professor at Harvard Medical School and the Harvard School of Public Health–said at the start of “How to Live When You’re Going to Die.” The audience chuckled. It would be the last chuckle for more than an hour, during which Gawande told story upon story of, as billed, death and dying. As in his piece for the magazine this summer on the role of palliative medicine, he talked about his struggles as a physician in talking to his patients with terminal illnesses about how they want to die.

While he was working on the piece, he told the audience, he was also battling these questions outside of work. His father was diagnosed with a spinal-cord tumor that went so high that removal would mean a near certain outcome of becoming a quadriplegic. His father, also a surgeon, began to lose feeling in his arm. But he continued to practice for six months, and claimed the nurses didn’t notice. At this, the audience laughed. That the first laugh line in an hour would come from a tale of the speaker’s father battling cancer–and performing operations with one dead arm–was telling of the mood in the room.

The last question came from a young woman who, like Sarah Monopoli, the lead character in Gawande’s recent piece on this topic, was pregnant when the cancer diagnosis came. In her case, it was her husband, not she, who had cancer. He was given an estimate of two years to live, but didn’t last that long. He died six months ago, she said, having discussed with her what he wanted from his final days and how he hoped she would raise their son.

Somehow, as the crowd emptied out onto Twenty-Third Street, the sun was still shining.